First trimester pregnancy: What to expect

The first trimester of pregnancy is marked by an invisible — yet amazing — transformation. And it happens quickly. Hormones trigger your body to begin nourishing the baby even before tests and a physical exam can confirm the pregnancy. Knowing what physical and emotional changes to expect during the first trimester can help you face the months ahead with confidence.

First trimester pregnancy: Your body

Consider common physical changes during the first trimester of pregnancy.

Bouts of nausea
Morning sickness, which can strike at any time of the day or night, sometimes begins as early as three weeks after conception. Nausea seems to stem at least in part from rapidly rising levels of estrogen and progesterone, which cause the stomach to empty more slowly. Pregnant women also have a heightened sense of smell, so various odors — such as foods cooking, perfume or cigarette smoke — might cause waves of nausea in early pregnancy.

To help relieve nausea, eat small, frequent meals throughout the day. Choose foods that are low in fat and easy to digest. It's also helpful to drink plenty of fluids. Avoid foods or smells that make your nausea worse. Try drinking ginger ale. For some women, motion sickness bands are helpful. For others, alternative therapies such as acupuncture or hypnosis offer relief. If you're considering an alternative therapy, get the OK from your health care provider first.

Contact your health care provider if the nausea is severe, you're passing only a small amount of urine or it's dark in color, you can't keep down liquids, you feel dizzy or faint when standing up, your heart is racing, or you vomit blood.

Tender, swollen breasts
Soon after conception, hormonal changes might make your breasts tender, tingly or sore. Or your breasts might feel fuller and heavier. Wearing a more supportive bra or a sports bra might help.

Increased urination
You might find yourself urinating more often than usual, especially at night. Pressure from your enlarging uterus on your bladder might cause you to leak urine when sneezing, coughing or laughing. To help prevent urinary tract infections, urinate whenever you feel the urge. If you're losing sleep due to middle-of-the-night bathroom trips, drink less in the evening — especially fluids containing caffeine, which can make you urinate more. If you're worried about leaking urine, panty liners can offer a sense of security.

Fatigue
Fatigue also ranks high among first trimester symptoms. During early pregnancy, levels of the hormone progesterone soar — which can put you to sleep. At the same time, lower blood sugar levels, lower blood pressure and increased blood production might team up to sap your energy. To combat fatigue, rest as much as you can. Make sure you're getting enough iron and protein. Include physical activity, such as a brisk walk, in your daily routine.

Food aversions or cravings
When you're pregnant, you might find yourself turning up your nose at certain foods, such as coffee or fried foods. Food cravings are common, too. Like most other symptoms of pregnancy, these food preferences can be chalked up to hormonal changes — especially in the first trimester, when hormonal changes are the most dramatic.

Dizziness
Pregnancy causes your blood vessels to dilate and your blood pressure to drop, which might leave you lightheaded or dizzy. Stress, fatigue and hunger also may play a role. To prevent mild, occasional dizziness, avoid prolonged standing. Rise slowly after lying or sitting down. If you start to feel dizzy while you're driving, pull over. If you're standing when dizziness hits, sit or lie down.

Seek prompt care if the dizziness is severe and occurs with abdominal pain or vaginal bleeding. This could indicate an ectopic pregnancy — a condition in which the fertilized egg implants itself outside the uterus. To prevent life-threatening complications, the ectopic tissue must be removed.

Heartburn and constipation
During first trimester pregnancy, the movements that push swallowed food from your esophagus into your stomach are slower. Your stomach also takes longer to empty. This slowdown gives nutrients more time to be absorbed into your bloodstream and reach your baby. Unfortunately, it can also lead to heartburn and constipation. To prevent heartburn, eat small, frequent meals and avoid fried foods, carbonated drinks, citrus fruits or juices, and spicy foods. To prevent or relieve constipation, include plenty of fiber in your diet and drink lots of fluids. Regular physical activity also helps.

First trimester pregnancy: Your emotions

Pregnancy might leave you feeling delighted, anxious, exhilarated and exhausted — sometimes all at once. Even if you're thrilled about being pregnant, a new baby adds emotional stress to your life.

It's natural to worry about your baby's health, your adjustment to motherhood and the financial demands of raising a child. You might wonder how the baby will affect your relationship with your partner or what type of parent you'll be. If you're working, you might worry about your productivity on the job and how to balance the competing demands of family and career.

You might also experience misgivings and bouts of weepiness or mood swings. To cope with these emotions, remind yourself that what you're feeling is normal. Take good care of yourself, and look to your partner and other loved ones for understanding and encouragement. If the mood changes become severe or intense, consult your health care provider for additional support.

Your relationship with your partner

Becoming a mother takes time away from other roles and relationships. You might struggle to retain your psychological identity as a partner and lover — but good communication can help you keep intimacy alive.

• Be honest. Let your partner know that you need support and tenderness, sometimes without sexual overtones. Identify the stress points in your relationship before they become problematic.
• Be patient. Occasional misunderstandings and conflicts are inevitable. Consider both sides. If your partner dives into work, for example, you may feel hurt and rejected because it appears as a withdrawal from your relationship. Your partner, on the other hand, might simply be trying to provide more security for your family.
• Be supportive. Encourage your partner to identify any doubts or worries. Do the same yourself. Discussing your feelings honestly and openly will strengthen your relationship and help you begin preparing a home for your baby.

Appointments with your health care provider

Whether you choose a family physician, obstetrician, nurse-midwife or other pregnancy specialist, your health care provider will treat, educate and reassure you throughout your pregnancy. He or she is there to help you celebrate the miracle of birth.

Your first visit will focus mainly on assessing your overall health, identifying any risk factors and determining your baby's gestational age. Your health care provider will ask detailed questions about your health history. Be honest. The answers you provide will help you and your baby receive the best care. If you're uncomfortable discussing your health history in front of your partner, schedule a private consultation.

Also expect to learn about first trimester screening for chromosomal abnormalities.

After the first visit, you'll probably be asked to schedule checkups every four to six weeks. During these appointments, raise any concerns or fears you might have about pregnancy, childbirth or life with a newborn. Remember, no question is silly or unimportant — and the answers can help you take the best care of yourself and your baby.

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